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PubMed1977

Reimplantation of a traumatically expelled tibial diaphysis.

The successful reimplantation and healing of a traumatically expelled tibial diaphysis in a 16-year-old boy is presented. Radionuclide scintimetry with 87mSr and 85Sr during the following months showed a pronounced diaphyseal activity corresponding to abundant periosteal bone formation around the dead cortical bone, increased activities over the fractures and the growth plates. Microscopical investigation after tetracycline labelling about 1 year after the accident showed a pronounced osteoblastic and osteoclastic activity in the superficial part of the cortex of the reimplanted bone. The endosteal part consisted of necrotic bone and was only to a small extent replaced by new bone. The uncomplicated healing process observed in this case can be attributed to the youth of the patient, the absence of infection and, most important of all, the preservation of the periosteum and its blood supply.

Adolescent↗
PubMed2005

Ruptured traumatic vertebral artery pseudoaneurysm in a child treated with trapping and posterior inferior cerebellar artery reimplantation. Case report and review of the literature.

The authors present the case report of a pediatric patient with a ruptured traumatic pseudoaneurysm of the intracranial vertebral artery (VA) from which the posterior inferior cerebellar artery (PICA) emerged. After considering multiple therapeutic options, the patient was treated surgically by trapping of the aneurysm segment and direct reimplantation of the PICA distal to the rupture site. In addition to presenting this unique case, the authors discuss the treatment of VA pseudoaneurysms and the various techniques for PICA revascularization. A review of the literature on PICA reimplantation is provided as an adjunct in the treatment of complex VA aneurysms.

Adolescent↗
PubMed2000

[Reimplantation of aortic valve; preliminary results in 13 patients].

OBJECTIVE: To evaluate our initial experience with the reimplantation technique of the aortic valve. DESIGN: Retrospective. METHOD: From January 1st 1998 to January 31st 2000, 13 patients were operated on by the technique as described by David. Mean age was 52.2 years (SD: 11). Median preoperative New York Heart Association (NYHA) functional class was 2/4 and median preoperative degree of aortic regurgitation was 3/4. Surgical indications were initially limited to aneurysmal disease of the aortic root (n = 6) and ascending aorta (n = 4), all complicated by aortic regurgitation. Later on, we also applied the technique in type A aortic dissection (n = 3). The repair was evaluated peroperatively by transoesophageal and postoperatively, by transthoracic echocardiography. The patients were followed postoperatively in the outpatient department. RESULTS: No technical problems arose that necessitated change or adjustment of the technique. Mean cardiac arrest time was 184 min (SD: 40) and cardiopulmonary bypass time 254 min (SD: 74). The primary aetiology on histopathological examination was medial necrosis in 5 patients and degenerative disease in the others. There was no early nor late mortality and none of the patients was reoperated upon the aortic root. Follow-up was complete at a mean of 12.3 months (SD: 8). Median aortic regurgitation at follow-up was 0.5 (p = 0.0001 versus preoperative) and median NYHA functional class at follow-up was 1 (p = 0.02 versus preoperative). CONCLUSION: David's aortic valve reimplantation technique was carried out with a low surgical risk and a low degree of residual aortic regurgitation in aneurysm of the aortic root, aneurysm of the ascending aorta and type A dissection with major destruction of the aortic root.

Adult↗
PubMed2001

Functional results of orthotopic ileal neobladder with serous-lined extramural ureteral reimplantation: experience with 450 patients.

PURPOSE: We report functional results of the orthotopic ileal neobladder using a serous-lined extramural tunnel as an antireflux procedure. MATERIAL AND METHODS: One-stage radical cystectomy and orthotopic ileal W-shaped neobladder creation were performed in 353 male and 97 female patients for invasive bladder cancer. The ureters were reimplanted using a serous-lined extramural tunnel for reflux prevention. Of the patients 344 were evaluable at a mean followup plus or minus standard deviation of 38 +/- 25 months. Evaluation included clinical and radiographic studies to determine functional and oncological outcomes. RESULTS: Four patients (0.8%) died in the hospital. Early complications in 42 patients (9%) were treated conservatively but 3 women underwent vaginal repair of a pouch-vaginal fistula. During the observation period there were 90 oncological failures, of which 3 were isolated urethral recurrence. Late complications included pouch stones in 10 cases, outflow obstruction in 11, mucous retention in 2, adhesive bowel obstruction in 3 and hypercontinence in 9 females. The incidence of daytime and nighttime continence was 93.3% and 80%, respectively. The upper tracts remain unchanged or improved in 96.2% of the reimplanted renal units, while reflux was observed in 3%. CONCLUSIONS: The serous-lined extramural tunnel has proved its efficiency and durability as an antireflux technique.

Adult↗
PubMed2002

Minimally invasive extravesical ureteral reimplantation for vesicoureteral reflux.

PURPOSE: We designed a new extravesical ureteral reimplantation technique with a minimally invasive approach from skin to ureterovesical junction with less perivesical tissue manipulation to avoid extensive bladder denervation. MATERIALS AND METHODS: Between July 1996 and December 2000, 37 boys and 52 girls 1.2 to 10.8 years old (mean age plus or minus standard deviation 3.8 +/- 2.5) (113 ureters) were treated with minimally invasive extravesical ureteral reimplantation. Vesicoureteral reflux was graded I to V in 8, 12, 43, 29 and 21 cases, respectively. The technique involves an approximately 10 to 15 mm. incision passing through the small triangular gap of the aponeurosis of the external abdominal oblique muscle and transversalis fascia to the point of the ureterovesical junction. The surgical field was exposed with mini-retractors and fine dissecting instruments were used to avoid unnecessary tissue manipulation. RESULTS: At postoperative followup 1 patient had persistent grade II reflux and 2 had moderate hydronephrosis and hydroureter, which resolved after 18 months. No patient returned due to voiding inefficiency or for pain control after discharge from the outpatient setting. CONCLUSIONS: This new technique can be easily used for vesicoureteral reflux with the advantages of simple intervention for surgeons, especially those with inguinal herniorrhaphy and antireflux surgery experience, and less wound discomfort for patients. The whole procedure can be performed on an outpatient basis. However, the decision to use this technique should be based on individual consideration.

Child↗
PubMed2002

Reimplantation of the two coronary ostia as a single button in Ross procedure.

A 10-year-old boy presented with severe aortic regurgitation due to a dysplastic aortic valve. He underwent a Ross procedure employing a mini-root replacement technique. At surgery, he was found to have eccentrically located coronary ostia which were both reimplanted as a single button into the pulmonary autograft. Postoperatively, multislice computed tomographic coronary angiography demonstrated satisfactory reimplantation of the coronary artery ostia with no evidence of kinking or compression of the coronary arteries. This case report supports the technique of transfer of coronary ostia as a single button where coronary anatomy is unfavorable for their individual transfer.

Aortic Valve Insufficiency↗
PubMed2002

[Laparoscopic transperitoneal replacement of the abdominal aorta with left renal artery reimplantation: experimental study on pigs].

OBJECTIVE: To study the feasibility and the tolerance of a combined laparoscopic transperitoneal aortic and renal restoration performed on animals. METHODS: Six pigs (mean weight: 79.5 kg, range 73-86) underwent laparoscopic replacement of the abdominal aorta using a 6-mm Dacron(R) graft, with direct reimplantation of the left renal artery. The study protocol was approved by the Advisory committee of Animal Ethics. The animal was placed supine on the operative table with a pillow under the lumbar region in order to raise the aortic area. A first midline, 10-mm diameter trocar was placed under direct vision, 5 cm above the pubis and allowed the insufflation of a 12-mm Hg pneumoperitoneum. One 30 degrees optic was used during the intervention. The pig was then tilted to a 30 degrees Trendelenbourg's position and two other 10-mm trocars were introduced 5 cm medially to the right and left antero-superior iliac spines ). Four other 10-mm incisions were necessary for introduction of an intestinal retractor, a suction-irrigation device and two laparoscopic aortic clamps. RESULTS: The procedure was performed in all animals in a mean operative time of 320 min (292-366), including ): - a time for aortic and renal artery dissection of 104 min (90-120), - a supra-renal aortic clamping time of 221 min (180-276), - a time for confection of proximal and distal aorto-prosthetic anastomosis of respectively 59 min (40-75) and 64 min (50-80), - a time for the left renal artery reimplantation of 72 min (40-140). Average blood loss was 525 ml (250-1050), and the mean pre and postoperative hemoglobin and pH values were 9.9 g/dl (8.9-10.7) versus 9.4 g/dl (8.5-11.3) and 7.36 (7.31-7.38) versus 7.30 (7.21-7.43) respectively. An angiogram ) performed before the sacrifice of animals showed a wide patent anastomosis in 18 (56%) cases, a<50% stenosis in 4 cases (22%), a > 50% stenosis in 1 case (5%) and a thrombosis of the first three renal artery restorations (17%) probably due to insufficient intraoperative heparinization. CONCLUSION: This experimental study shows the feasibility of laparoscopic transperitoneal abdominal aortic restoration with re-implantation of the left renal artery (fig. et ). The techniques of arterial sutures must be improved in order to decrease aortic and renal clamping times.

Anastomosis, Surgical↗
PubMedDate not supplied

Reimplantation of autoclaved or irradiated cortical bones invaded by soft tissue sarcomas.

BACKGROUND: Bone defects after excision of malignant bone and soft tissue tumors are usually reconstructed by autogenous bone grafting or allografting. PATIENTS AND METHODS: We treated 2 patients who had soft tissue sarcomas with bone involvement, the first by excision and reimplantation of the hemicortical autogenous cortical bone graft after autoclaving and the second with intraoperative irradiation. RESULTS: In both patients, postoperative follow-up radiographic studies showed incorporation of the implanted bones into the host bones within 12 months. Biopsy of the implanted bone performed 3 years after surgery showed many viable osteocytes, and blood vessel invasion into Harversian canals. No complications regarding the reconstructive techniques were observed during the postoperative period. CONCLUSION: The reimplantation of autogenous cortical bones after autoclaving or irradiation is a useful reconstructive method for partial bone defects in soft tissue tumor surgery.

Adult↗
PubMed2003

[Prevention of ischemic colitis following aortic reconstruction: personal experience of the role of transmural oximetry in the decision for inferior mesenteric artery reimplantation].

BACKGROUND: The colonic ischemic necrosis is one of the most serious complication in the surgical reconstruction of abdominal aorta aneurysm (AAA) due to surgical inappropriate binding of the inferior mesenteric artery (IMA). METHODS: A retrospective analyzed of a group of 118 infrarenal AAA surgically treated is presented. RESULTS: The most common cause of ischemic colitis (75% of cases) is the surgical binding of an opened IMA or its failed reimplantation. CONCLUSIONS: In this paper according to their personal experience and the literature data, the authors outline a diagnostic behaviour to select the patients needing the reimplantation of IMA; they suggest to complete the pre operative information with an instrumental evaluation during the surgical treatment.

Aged↗
PubMed1992

[Vesico-ureteral reimplantation on psoas bladder in lesions of the pelvic ureter. Review of 50 patients].

Between 1979 and 1991, the authors performed 50 psoas bladder ureterovesical reimplantations for lesions of the pelvic ureter. 90% of very good results were obtained with this technique at the cost of a low morbidity. This series confirms the influence of previous pelvic radiotherapy on the postoperative complication rate. On the basis of the excellent results in this series, confirmed by those reported in the literature, this technique can be proposed as treatment of choice for lesions of the pelvic ureter when suture-resection or simple reimplantation cannot be performed after failure of endoluminal dilatation in patients with a life expectancy greater than 6 months to one year.

Adolescent↗
PubMed2004

Endodontic treatment of reimplanted avulsed teeth.

By using an appropriate storage system such as a Save-A-Tooth and having knowledge of appropriate treatment options, an avulsed tooth can be reimplanted with the greatest chance of success. Using the different categories of avulsed teeth discussed in this article as a guide, the clinician can determine the most applicable course of treatment. If endodontic treatment is based on the clinical condition of the pulp and PDL cells, the chance of success following reimplantation is improved.

Follow-Up Studies↗
PubMed2004

[Cochlear reimplantation].

OBJECTIVE: To analyze retrospectively the outcome of 6 cases of cochlear reimplantation to summarize its experience. METHODS: The operation method of cochlear reimplantation was similar to routine cochlear implantation. A "H" incision for the muscle-periosteum was used to shorten the operation time. RESULTS: Of all the cases, the electrodes are successfully and totally inserted into the cochlea. The causes for revision are different. The electrode was found to be not in the proper situ of the cochlea after the first operation in one patient. The out part was ruptured because of trauma in another patient. The causes of the other four patients were unknown. CONCLUSIONS: The incision should not be too small. The control electrode should be put beneath the periosteum. The site used to fix up the out part need be burnished. Unabsorbable suture should do not be used. It is important to insert the new electrode quickly after drawing the old one out. The time to accommodate the new electrode often needs 3-4 weeks.

Adolescent↗
PubMed1991

[Revascularization of coronary arteries. Reimplantation of the right internal mammary artery into the left in situ mammary artery].

The distal latero-circumflex arteries and the posterior descending artery are located so far from the mammary arteries that they cannot be revascularized by the conventional procedure. Reimplantation of the right internal mammary artery (RIMA) used as a free graft into the left internal mammary artery (LIMA) in situ doubles the length of the RIMA, thus enabling the distal coronary arteries (lower lateral or posterior interventricular arteries) to be bypassed. The Y-shaped reimplantation anastomosis technique is described, and the immediate results obtained in 25 patients are reported. Seven angiographic controls were performed after 6 months to 1 year, and 6 anastomoses were perfectly patent. One RIMA is occluded (major competitive flow).

Coronary Disease↗
PubMedDate not supplied

[The surgical treatment of aneurysms of the ascending aorta with associated aortic insufficiency. Total replacement with reimplantation of the coronary arteries].

We reviewed our experience with replacement of the ascending aorta and aortic valve with a composite graft and reimplantation of coronary arteries to the tube graft during 8 years interval from April, 1982, to April 1990. 24 patients underwent repair, the mean age was 49.83 years. Annuloaortic ectasia was the most common indication (58.33%), followed by aortic dissection (acute or chronic). Emergency operation was carried out in nine patients with aortic dissection (37.5%) and elective in 15. The mean duration of cardiopulmonary bypass was 118 +/- 4 minutes and of aortic clamping 83.85 +/- 2 minutes. Hospital mortality was 4.17%, reoperation for hemorrhage was 12.5% and perioperative morbidity for other causes was 34.7%. There were one late death. 20 patients were follow-up with a total of 638 patients-months (two patients excluded with insufficient follow-up and one late death). At last follow-up 14 patients were in functional class I. Eight year actuarial survival for the 24 patients was 91%. We believe that replacement of the ascending aorta and aortic valve with a composite graft and coronary arteries reimplantation to the tube graft is more than one satisfactory alternative to supracoronary graft replacement and aortic valve replacement. It offers the advantage of excluding all abnormal aortic tissue, eliminating the risk for later development of complications in the non excluded disease aorta. It supposes the method of choice for patients with anuloaortic-ectasia, aneurysms of the sinuses of Valsalva with aortic insufficiency, and aortic dissection with proximal affectation of coronary arteries and aortic valve.

Adult↗
PubMed1991

Techniques of ureteric reimplantation in kidney transplantation and its related urological complications.

Two common techniques of ureteric reimplantation for kidney transplantation, the Politano-Leadbetter and the extravesical ureteroneocystostomy are described in detail. Correct techniques of donor ureter harvesting, appropriate method of reimplantation and judicious use of double J stent are also emphasised so as to reduce the urological complications which occurred in about 7% to 15% in most series. More than 90% of urological complications are due to urinary fistulae and ureteric obstruction which carry a significant morbidity and mortality. The causation, diagnosis and management of these complications are reviewed. Early diagnosis and early aggressive surgical treatment is the key to a successful outcome.

Cystostomy↗
PubMed1991

Complications of splenic tissue reimplantation.

Splenic tissue reimplantation employing the omental implantation technique was applied in 23 patients undergoing splenectomy for traumatic or iatrogenic splenic injury. Four complications were encountered after autotransplantation (17.4%). Two of these consisted of small bowel obstruction due to postoperative adhesions and were successfully managed by lysis of the adhesions. The other two complications were aseptic necrosis of the splenic transplants and were treated with ablation of the autolysed transplants. A case of abnormal splenic tissue reimplantation in a male patient with unsuspected myelofibrosis is also discussed. He underwent an emergency laparotomy for rupture of a subcapsular splenic haematoma. It is concluded that splenic tissue implantation in the greater omentum is associated with important early morbidity and this should be taken into account whenever application of the method is considered.

Adolescent↗
PubMedDate not supplied

[The significance of the cellular factor in realizing the restorative effect of the procedure of bone marrow exfusion, incubation and reimplantation in irradiated mice].

In experiments with F1 (CBA X C57Bl) mice irradiated with doses of 6.5 to 8.5 Gy the evidence was obtained for the important role of the reimplanted cells in a complete realization of the reparative effect of exfusion, incubation and reimplantation of bone marrow. The increase in radiation dose was accompanied by a tendency towards the decrease in the efficacy of the procedure, and, perhaps, by changes in the ratio of roots of haemopoietic stem cell differentiation.

Animals↗